The impact of fasting and treatment omission on susceptibility to hypoglycaemia in children and adolescents with gh and cortisol insufficiency
Open accessAbstract
Objective Hypoglycaemia may be a frequent occurrence in young GH deficient patients and so we studied the response to fasting in children and adolescents with GH and/or cortisol deficiency. Methods A total of 20 patients (2-18 years) fasted for 14 h (22.00-12.00 h) on two occasions as part of a randomized cross-over study. Fourteen had pituitary hormone deficiency (PHD) including GH deficiency (GHD). Of the 14 patients, seven were ACTH sufficient (PHDC+) and seven ACTH deficient (PHDC-). Six had primary adrenal failure (PAF). Subjects administered or omitted their normal dose of evening GH and/or morning hydrocortisone. Glucose, insulin, GH, cortisol, ketones and catecholamines were measured at 04.00 h and regularly from 07.00 to 12.00 h. Insulin sensitivity was assessed by HOMA and hypoglycaemia defined as a blood glucose (BG) Results BG was related to age and body mass index on treatment but no subject became hypoglycaemic on or off therapy prior to 07.00 h. Five children (aged 3, 4, 7, 8 and 11 years) were hypoglycaemic between 07.00 and 12.00 h off treatment. There was a positive relationship between GH AUC and minimum BG in patients with PHD on treatment (r(2) = 0.45, P = 0.012) with increased insulin sensitivity off treatment. Increased cortisol levels were seen in PHDC+ patients off GH (P Conclusions Unrecognized overnight hypoglycaemia in children and adolescents on pituitary hormone replacement is uncommon but BG levels quickly become abnormal when treatment and meal…
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Children with adrenal insufficiency are prone to hypoglycaemic events if they are not compliant with their steroid replacement.
“Children with AI are prone to hypoglycaemic events if they are not compliant with their steroid replacement (53).”
From Hypoglycaemia in adrenal insufficiency (2023) · cites this paper as [53]
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Independent Effects of Youth and Poor Diabetes Control on Responses to Hypoglycemia in Children
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Hypoglycaemia in adrenal insufficiency
Lee, S. C., Baranowski, E. S., Sakremath, R., Saraff, V., & Mohamed, Z. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1198519 · Cited by 32 · see citing works
- Authors
- Johnstone, H. C., McNally, R. J. Q., & Cheetham, T. D.
- Affiliations
- Royal Victoria Infirmary (GB)
- Corresponding author
- Cheetham, Tim D.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2008-08-13
- Volume
- 69
- Issue
- 3
- Pages
- 436-442
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2163058481
- Cited by
- 7
- References
- 4
- Citations by year
- 2025: 1 · 2023: 1 · 2018: 1 · 2012: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- hypoglycemia, growth hormone deficiency, cortisol deficiency, Addison's disease, pituitary hormone deficiency, fasting, cortisol, growth hormone replacement therapy, insulin sensitivity, catecholamines, ketones, body mass index, children and adolescents, nocturnal hypoglycemia, treatment omission, ACTH deficiency, HOMA-IR
- MeSH terms
- Adolescent, Adrenal Insufficiency, Blood Glucose, Child, Child, Preschool, Disease Susceptibility, Fasting, Female, Growth Disorders, Humans, Hydrocortisone, Hypoglycemia, Male, Patient Compliance, Body Mass Index, Cross-Over Studies, Human Growth Hormone
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